chap 38

Question 1

factors that influence fecal elimination

Answer 1

• development
• food/fluid intake
• activity and muscle tone
• lifestyle
• psychologic factors
• defecation habits
• medications/laxatives
• diagnostic procedures
• anesthesia
• pregnancy
• pathologic condition
• pain
• positioning

Question 2

common bowel problems

Answer 2

• constipation
• impaction
• diarrhea
• incontinence
• flatulence
• hemorrhoids

Question 3

constipation

Answer 3

• decreased frequency of defecation
• hard, dry, formed stools
• painful

Question 4

causes of constipation

Answer 4

• insufficient fiber/fluid intake
• insufficient activity
• irregular habits
• medications

Question 5

causes of diarrhea

Answer 5

• stress
• medications
• allergies
• intolerance of food/liquid
• disease of colon

Question 6

fecal impactions

Answer 6

• mass/collection of hardened feces in rectum

- causes: poor defecation habits, constipation

Question 7

bowel incontinence

Answer 7

loss of voluntary ability to control fecal and gaseous discharge

Question 8

measures to maintain normal fecal elimination

Answer 8

• timing
• positioning
• privacy
• nutrition
• exercise

Question 9

nursing interventions to promote bowel elimination

Answer 9

• toileting routinely and timely
• teach about diet/medication
• administer enemas
• digital removal of fecal impaction
• bowel training programs
• fecal incontinence pouch
• ostomy management

Question 10

aspirin stool

Answer 10

pink-red-black

Question 11

iron stool

Answer 11

black

Question 12

antacid stool

Answer 12

white-speckled

Question 13

antibiotic stool

Answer 13

green-gray

Question 14

digital removal of stool

Answer 14

• last resort
• physician order is necessary
• procedure is very uncomfortable for patient

Question 15

nursing interventions for a patient with diarrhea

Answer 15

• answer call bell immediately
• remove the cause of diarrhea when possible
• if impacted, get physician order
• give special care to region

Question 16

types of enemas

Answer 16

• cleansing
• carminative
• retention

Question 17

cleansing enema

Answer 17

• prevents escape of feces in surgery
• prepare intenstines for diagnostic testing
• removes feces

Question 18

carminative enema

Answer 18

used to expel flatus

Question 19

retention enema

Answer 19

introduce oil/medication into the rectum and sigmoid colon

Question 20

enema administration

Answer 20

• sterile in NOT necessary
• wear gloves
• explain procedure
• take precautions

Question 21

common enema solutions

Answer 21

• isotonic: less likely to cause electrolyte imbalance, distends colon, stimulate peristalsis, softens feces
• soapsuds: irritate mucosa
• oil: lubricates feces and colonic mucosa
• hypertonic: draws water into colon
• hypotonic: distends the colon, stimulates peristalsis, softens feces

Question 22

position for administering enemas

Answer 22

sims

Question 23

ostomy

Answer 23

surgical opening

Question 24

colostomy care

Answer 24

• keep pt as free of odors as possible
• inspect the pt’s stoma regularly
• measure the pt’s fluid intake and output
• explain each aspect of care to the pt
• encourage pt to care for and look at ostomy

Question 25

care of stoma

Answer 25

- keep the skin dry & clean around the stoma site - normal stoma should appear red and may bleed slightly when touched - assess the peristomal skin for irritation each time the appliance is changed - treat any irritation/skin breakdown immediately - keep skin clean by washing off any excretion with warm water and drying solution - protect skin, collect stool, and control odor with an ostomy appliance

Question 26

patient guidelines for stool collection

Answer 26

- void first so that urine is not mixed in - defecate into the container rather than toilet - do not put toilet paper in bedpan - notify nurse when specimen available